A Career of Your Calling

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

As an External Compliance Analyst, you will play a vital role in supporting the organization in maintaining compliance with regulatory requirements, achieving its overall goals, and ensuring the integrity and accountability of its operations. In this role, you will be responsible for supporting the execution of the First tier (FDR) entities/Subcontractor determination process for the Medicare and Medicaid lines of business. You will assist in the FDR/Subcontractor determination process, pre-delegation assessments, support compliance monitoring and assessments, and help collect and review attestations to ensure FDR/Subcontractor operations follow the applicable Federal and State regulations. The position currently reports to the Manager, External Compliance and Regulatory Audit.

Your Responsibilities

• Support the execution of the First tier (FDR) entities/Subcontractor determination process for the Medicare and Medicaid lines of business. Assist in conducting reviews for pre-delegation, attestations, and abridged compliance assessments of FDR/Subcontractors.

• Act as a compliance resource by updating metrics for monitoring dashboards, policies and procedures, tracking documents, and assessment work papers.

• Provide support in the review of existing contractual language or development of new contractual language with third-party agreements.

• Assists the team in responding to requests through research and analysis of new and existing statutory, regulatory, legal, and other requirements.

• Assists in the implementation of assessment plans, self-assessments and other activities to monitor and track compliance.

• Participates in cross trainings and may support Enterprise Ethics & Compliance senior staff on assessments, special projects, and external regulatory audits.

Required Skills and Experiences

• 3+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

• 1+ years of experience with Compliance assessments, monitoring, auditing, or general knowledge of Federal and State health care regulations (Medicare & Medicaid).

• Well-developed analytical, problem solving and communication skills.

• Proficient with Microsoft tools (Excel, Word, PowerPoint, etc.).

• Strong oral and written communication and collaboration skills.

• Demonstrated ability to develop effective relationships through engagement with others.

• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor's degree or other advanced degree

• Professional certification (e.g. CHC, PMP, CIA, CPA).

• Demonstrated ability to improve performance and adapt readily to changing work goals.

• Business analysis expertise and ability to translate regulatory requirement into operation.

Compensation and Benefits:

Pay Range: $67,200.00 - $89,100.00 - $111,000.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.